Please confirm that you would like to log out of Medscape.
If you log out, you will be required to enter your username and password the next time you visit.
Log outCancel

Physician Suicide Chat

Every year, approximately 400 U.S.-based physicians commit suicide, the equivalent of an entire medical school.

This issue is of major concern to Medscape readers. In fact, a recent Medscape Perspective article on physician suicide garnered over 800 comments. The American Psychiatric Association along with suicide expert Dr. Michael Myers will participate in this chat and answer your questions.

Thanks for joining us today for a discussion about physician suicide. The American Psychiatric Association along with Dr. Michael Myers, Professor of Clinical Psychiatry at SUNY-Downstate Medical Center in Brooklyn, NY, are here to answer questions about this important topic.

It's not entirely clear why some people die by suicide while others, who face similar life adversity, don't. Medscape Psychiatry recently featured a news article on suicide biomarkers getting closer to the clinicSuicide Biomarkers Getting Closer to the Clinic

The aggregate suicide rate ratio for male physicians, compared to the general population, was 1.41. For female physicians the ratio was 2.27. Studies on physicians’ suicide collectively show modestly (men) to highly (women) elevated suicide rate ratios. To put it another way, the rate of physician suicide in men and women is equal.

Can you please discuss the issue of possible stigma by non-mental health M.D.'s, why you think it persists despite growing understanding of mental health problems as, at least in part, neurobiology in origin etc.

This study listed burnout, quality of life and depressive symptoms as possible predictors of suicidal ideas among US Medical students. Could the difficulty of maintaining a healthy work/life balance for a med student or physician be a contributing factor for the higher rate of suicides among the profession?

Yes – physicians who are open about a family history of suicide, a previous history of suicidal acts, a previous bout of major depressive disorder with a suicidal diathesis, a current depression that is increasingly treatment refractory, a physician with bipolar illness that is rapidly cycling and poorly treatment adherent, a physician with burnout and/or SUD with many losses and few supports, a physician facing a humiliating lawsuit or medical licensure investigation, a physician living with a chronically progressive and debilitating medical disorder (including pain)No – note the number of doctors who are below the radar or who fall through the cracks each year where no one saw it coming – are these physicians who fit into the 10-15% of suicide deaths without a psychiatric illness or are they individuals who masterfully cover up their pain and desperation?

It is troubling that women physicians rates are the same as male physicians. Are they not getting proper support for the medical work and family responsibilities they juggle? Are they getting good care by knowledgeable practitioners?

What about the workload, balancing family life and medicine can be very hard to do, and it can become depressing if you are so overwhelmed with too much hours needed at the hospital. What if there were more residency spots and thus, more residents who could then be integrated into a type of shift schedule where everyone gets adequate rest and relaxation and recuperation. Being an M.D. is not easy, especially when you are doing it alone. Make more residency spots and so more people can manage the wards and everyone can have adequate family time, rest relaxation. What do you think?

There is heavy emphasis in med. school on being correct, not being wrong. The issue of a physician facing a humiliating lawsuit or licensure investigation runs counter to our (unrealistic) expectation that M.D.s are never to be wrong.

As a woman Physician I have this to say: If my family is not happy and healthy, then I am not happy and healthy, and if I am not happy and healthy i.e. my brain won't be healthy, then my patients cannot possibly be happy and healthy and so I think more should be done to ensure Physicians, and their families are happy and healthy.

Abigail - we all need to examine our perfectionism. Senior docs need to openly admit to trainees their doubts and insecurities at times in their career. We are human. To err is human. Law suits need re-examination!